First Day in the OR

by admin

Observation Only my Butt!

Today was my first “Observation Day” in the OR as a Student Registered Nurse Anesthetist (SRNA).  My TRUE clinical rotation starts in May but today was my opportunity to get into the OR, apply some of the things I have learned and to finally get my hands on an airway! It was a low pressure situation because our preceptors know that we are only 8 weeks into the program.  In other words, the expectations are low.  *And those are my favorite kind of expectations because I can meet them easily!  We weren’t supposed to do much today but I had a great preceptor who let me do a lot more than observe and it was great!

I HEART NURSE ANESTHESIA

(After the first day that is!)

Even though I had to wake up at 4am to be in the hospital parking lot by 5:15am, I had a good day today.  We had a very straightforward Anterior Cervical Discectomy & Fusion.  The patient had some right sided numbness and tingling but retained good range of motion in her neck- so we did not have any difficulty placing her head in an appropriate position for intubation.  Might I say…intubating a human is very different from intubating a dummy.  AND, I actually managed to successfully get the breathing tube into the right hole with my first patient.  I was like, hey- where is my high five??

But nooo, you don’t get a high five because you are busy listening to breath sounds, attaching your ventilator, adjusting your O’s and charting crap.  But inside my head, I did a little jump of joy.

Introduce Yourself!

Even though it was intimidating, I introduced myself to everyone- including the Anesthesia Tech, OR Circulator, the Scrub RN, the Surgical Fellow and the 2 Surgeons.   The senior class gave us this advice and I think it is definitely the best strategy to use when you’re new and you’re in a huge facility like the one I am in.  There is a big learning curve but I tried to help out where I could- by flushing IV tubing, applying monitors, and staying out of the way.

Get Used to Feeling Silly

Many people have told us that we would struggle with the most simple tasks during our first rotations.  I did not really believe them until today.  I felt like a complete klutz and I felt like everything I did as an ICU Nurse was taking me twice as long as it usually does.  I even had trouble attaching the EKG leads!  (It’s different when you’re at the patients head of the bed instead of at the side ok people?)

More Troubles…

I had trouble flushing the IV tubing.  Anesthesia providers attach ports and several sets of extension tubing so you get more bubbles in your line.  My CRNA Preceptor showed me how to squeeze the IV bag to flush quickly and blow out those air bubbles.  He also asked me to grab some Decadron at one point and for the life of me I could not find it.  So I wish I could tell you I went in gracefully and was a great addition to the team but honestly…that’s not really true.

Good News

But the good news is- you can still mess little things up and have a great day.  The patient woke up very smoothly and comfortably and her vital signs remained fairly stable throughout the case.  At the beginning we gave a bump of Ephedrine and some Neosynephrine when she didn’t respond to Ephedrine but then all the numbers looked great.  I was scheduled to be in the OR from 5:30-11am and we dropped our patient off safely in PACU at 10:45 so I was lucky that I was able to see one entire case from start to finish.  Next time I’m in the OR isn’t until the end of March but I already can’t wait!

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